Specialty Therapies Drive Significant Increase in US Drug Spending in 2014

Spending on specialty drugs took a record rise in the US in 2014, largely due to new expensive, yet effective, hepatitis C drugs, according to new data released today in the 2014 Express Scripts Drug Trend Report.

According to the pharmacy benefit manager’s (PBM) report, new hepatitis C drugs’ high prices and exploitation of loopholes for compounded medications drove a 13.1 percent increase in US drug spending last year, the fastest rate of increase in more than a decade. Hepatitis C and compounded medications are responsible for more than half of the increase in overall spending. Express Scripts, the largest PBM in the US, said that excluding these two therapy classes, the 2014 drug trend was 6.4 percent.

In 2014, new hepatitis C pills entered the market with high price tags, such as Gilead Sciences’ Sovaldi, which costs about $1,000 per day, or $84,000 for a 12-week course of treatment.

Last year, in a forecast Express Scripts said that the trend in specialty drugs will more than double in 2014. According to the report, specialty drugs, including conditions like cancer, multiple sclerosis and hepatitis C, made up more than 31 percent of drug spending in 2014. While hepatitis C drugs had the second lowest prescription volume among the top ten specialty conditions, it accounted for 45 percent of the total increase in specialty spend.

“For the past several years, annual drug spending increases have been below the annual rate of overall healthcare inflation in the US, but the paradigm is shifting dramatically as prices for medications increase at an unprecedented and unsustainable rate,” said Glen Stettin, MD, Senior Vice President, Clinical, Research and New Solutions at Express Scripts. “Now, more than ever, plans needed to tightly manage the pharmacy benefit, implement smarter formularies, control compounded medication use and offer the right clinical support to ensure all patients are able to achieve the best possible health outcomes at a price our country can afford.”

Compared to 2013, the US spent nearly 743 percent more on hepatitis C drugs in 2014. This increase reflects the arrival of new pills including Gilead Sciences’ Sovaldi and Harvoni and AbbVie’s Viekira Pak. According to Express Scripts, its hepatitis C solution, which makes Viekira Pak an exclusive option to all Express Scripts members, is expected to save their clients $1 billion in 2015.

In addition to new hepatitis C drugs, Express Scripts anticipates high price tags for new cancer drugs and PCSK9 inhibitors for high blood cholesterol, challenging payers. The company said that PCSK9 inhibitors alone could one day cost the US healthcare system an estimated $100 billion per year. At a previous conference, Express Scripts CEO George Paz said that new cancer drugs and PCSK9 inhibitors will be the company’s next target for price negotiations.

Source: Express Scripts

Last updated: 3/10/15; 11:40am EST

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